17D2191813 CLIA NUMBER - WALGREENS #06170

Laboratory Demographics

  • CLIA Code: 17D2191813
  • Facility Name: WALGREENS #06170
  • Facility Address: 555 N MAIZE RD
    WICHITA, KS
    ZIP 67212
  • Facility Phone: 316 729-6171
  • Facility Type: Other - COVID-19 TEST SITE
  • Facility Type: Waiver
  • Lab Director: BRADLEY C. SEILER
  • NPI Number: 1417962630
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2191813
LAB Type Other - COVID-19 TEST SITE
Facility Name WALGREENS #06170
Street 555 N MAIZE RD
City WICHITA
State KS
ZIP 67212
Phone 316 729-6171
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Other - COVID-19 TEST SITE
Lab Director BRADLEY C. SEILER

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This page was last updated on: 9/29/2025